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| Spot research on different strategies of preconceptional health examination in Gansu province |
| 1. Gansu Family Planning Science and Technology Service Center, Lanzhou, Gansu Province, 730099；2. National Research Institute for Family Planning；3. Graduate School of Peking Union Medical College |
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Abstract To explore a suitable strategy of preconceptional health examination for the western region of China. Methods: Three sample points were selected from Gansu province to conduct a spot study of three different strategies for preconceptional health examination, including Zhuanglang County, Liangzhou District, Zhangjiachuan Hui autonomous County. The risk identification rates and costs of different strategies were collected. The cost-effectiveness ratio (CE) of different strategies was analyzed to evaluate the applicability of strategies. Results: In the pilot areas, the detection rates of high-risk population by the first (as the current pre-pregnancy health examination strategy), the second, and the third strategies of preconceptional health examination were 79%, 69.6%, and 91.7%, respectively. The cost of the first, the second, and the third strategies were 475.33 Yuan per couple, 249 Yuan per couple, and 662.67 Yuan per couple, respectively. The cost-effectiveness ratios of the three strategies were also calculated. The CEs for the three strategies were 601.68 Yuan/case, 357.76 Yuan/case, and 722.65 Yuan/case, respectively. Compared with that of the second strategy, the incremental cost-effectiveness ratio (marginal cost) of the first and the third strategies were 2407.77 Yuan/case and 1475.12 Yuan/case. Conclusion: The second strategy of preconceptional health examination, including the required items in Chinese guideline of preconception and pregnancy services (2018), has the beat economical efficiency.
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